title: [Early diagnosis by opportunistic screening in cancer of the prostate. Results of a 1-year protocol. Comparison with historical data].
abstract: BACKGROUND
  The high prevalence of Prostate Cancer (PC) and long survival of patients with advanced disease, added to the high cost of palliative treatment (hormone therapy), versus the existence of curative therapies at earlier stages, fully justify the campaigns for early diagnosis. The objective of the study was to increase the number of cases diagnosed at local stages, using an opportunistic screening methodology.
  
  
  METHODS
  All male patients between 50-70 years of age, seen over one year in Urology and primary care in CAP-Barceloneta because of urinary symptomatology, were included in a screening program. This cohort were performed total PSA determination and digital rectal examination. When digital rectal examination was suspicious and/or PSA values higher than 4 ng/ml, they underwent echo-guided prostate biopsy.
  
  
  RESULTS
  A total of 595 male were seen; 43.9% met the inclusion criteria; 39.4% were rated as suspicious, neoplasia being confirmed in 51% of these. Prevalence of PC in this cohort was 20.1%, half of them in local stage.
  
  
  CONCLUSIONS
  Populational screening in PC has proven to be ineffective from a health care standpoint, as opposed to opportunistic screening. Overdiagnosis was not significant, although there were more cases diagnosed in organ-confined stages, this is, eligible for curative therapy; thus, hormone therapy and the resulting morbidity were significantly decreased; quality of life of patients under curative treatment was improved; there was a large reduction of health care costs and, although it will have to be further confirmed in large multicentre series, we believe survival was improved.
authors.affiliation: Servicio de Urología, Hospital del Mar Grup de Recerca Uro-oncològic-IMIM, Facultad de Medicina, U.A.B. Barcelona.
authors.forename: A
authors.initials: A
authors.lastname: Gelabert Mas
authors.forename: O
authors.initials: O
authors.lastname: Arango Toro
authors.forename: J
authors.initials: J
authors.lastname: Carles Galcerán
authors.forename: O
authors.initials: O
authors.lastname: Bielsa Galí
authors.forename: R
authors.initials: R
authors.lastname: Cortadellas Angel
authors.forename: M
authors.initials: M
authors.lastname: Herrero Polo
authors.forename: J
authors.initials: J
authors.lastname: Griñó Garreta
authors.forename: P
authors.initials: P
authors.lastname: Foro Arnalot
authors.forename: G
authors.initials: G
authors.lastname: Nohales Taurines
authors.forename: N
authors.initials: N
authors.lastname: Carrasco Cánovas
mesh_terms: D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010173:Palpation; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen
vernacular_title: Diagnóstico precoz por cribado oportunístico en cáncer de próstata. Resultados de un año de protocolo. Comparación con datos históricos.